NHS CONTINUING HEALTHCARE (CHC)
What is NHS Continuing Healthcare?
It’s a package of care arranged and paid for by NHS Clinical Commissioning Groups (CCGs) for people aged 18 years and above who have significant ongoing healthcare needs and have been assessed as having a ‘primary health need’. People assessed for CHC include those who need a very high level of support.
What is a Clinical Commissioning Group?
Clinical Commissioning Groups (CCGs) are clinically-led statutory NHS organisations responsible for planning and paying for healthcare services for their local population. At West Hampshire CCG we are run by a governing body of local GPs. We work with our partners to help people live healthy lives and ensure they have access to the best healthcare services possible. [Do you want to say you are the lead CCG for CHC?]
What is a ‘primary health need’?
This is the key factor used to decide whether your care needs will be met by the NHS or your local authority. If dealing with issues around your health is the most important part of your care needs, and is greater than your social care needs (washing, dressing, feeding), then you will have what’s called a ‘primary health need’. You can ask the CHC team for more information.
How do I apply?
You can speak to your GP, nurse or social worker or any other healthcare professional involved in your care. Ask them to arrange an appointment for you where you can be assessed.
Do I need to agree to an assessment?
Yes. You, or your power of attorney, must agree to the assessment before it begins and before any decisions are made. You’ll be asked to give your written consent. This means you are ok to be asked questions about your health and your care needs. It also means you are happy for us to talk to other people who know and support you, such as your family, GP, nurse and social worker.
Does referral from an initial checklist screening mean I will be eligible for CHC?
No. It’s a step in the process. Completing the CHC checklist doesn’t necessarily mean you’ll be eligible for CHC. You will need to have a full assessment first.
Who carries out the initial checklist screening?
It’s usually carried out by a health or social care professional who knows you.
Who carries out the full assessment?
It is usually carried out by a multidisciplinary team which is a group of health and social care staff, such as a GP, nurse, therapist, or social worker. Most of the time it is the CCG who carries this out, but if demand is particularly high we can pay for another suitably qualified organisation to carry it out to avoid delays.
Where does the assessment take place?
It can take place in your home, in a hospital, or in a care or nursing home.
Who decides if I am eligible for CHC funding?
The multidisciplinary team make a recommendation to the CCG about whether they think you may be eligible or not. Then the CHC team at the CCG make the final decision.
Will my finances have an impact on the assessment?
No. However, if you are eligible for CHC, we can take account of comparative costs and value for money when arranging care.
What happens if there is a delay in informing me I’m eligible for CHC?
You should usually hear whether you are eligible within 28 calendar days of completing the checklist or full assessment. If you are eligible and it takes longer than 28 days to decide this and the delay is unjustifiable, we will refund any costs from the 29th day until the date of the decision.
Once I get CHC funding will it continue indefinitely?
Not necessarily. You will be assessed three months after you receive your care package and then reviewed every year afterwards. This is so we can check that the care provided is still meeting your needs , that you are getting the right support and to ensure CHC is still needed.
What if I’m not eligible?
If you have any concerns, you do have the right to appeal the decision. Our CHC team at West Hampshire CCG can provide you with advice and information about this. You can call us on: 0300 123 4448 or email us at WHCCG.firstname.lastname@example.org
How likely is it for someone to be eligible for CHC?
Not everyone who applies will be eligible. Only around X% of people, or XX in 100 who apply will receive funding.
Who can I contact if I have further questions?
You can contact the CHC team at WHCCG on: 0300 123 4448 or email us at WHCCG.email@example.com
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